{"id":774,"date":"2026-04-19T14:12:37","date_gmt":"2026-04-19T14:12:37","guid":{"rendered":"https:\/\/ulemnrme.a2hosted.com\/wordpress\/?page_id=774"},"modified":"2026-06-19T21:28:51","modified_gmt":"2026-06-20T04:28:51","slug":"parathyroid","status":"publish","type":"page","link":"https:\/\/diaendo.com\/index.php\/parathyroid\/","title":{"rendered":"Parathyroid Disorders"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dParathyroid Disorders & Calcium Metabolism\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to understanding the parathyroid glands, primary hyperparathyroidism, and when treatment is needed.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text]<\/p>\n<style>.de-toc{background:transparent;border:none;border-radius:0;padding:0;box-shadow:none;margin:0 0 6px;}.de-toc-label{font-size:.74rem;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#149d79;margin:0 0 12px;text-align:center;}.de-toc-inner{display:flex;flex-wrap:wrap;gap:10px;justify-content:center;}.de-toc-pill{display:inline-block;font-size:.86rem;font-weight:600;line-height:1;padding:9px 16px;border:1.5px solid #149d79;border-radius:999px;color:#149d79;text-decoration:none !important;white-space:nowrap;transition:background .15s ease,color .15s ease;}.de-toc-pill:hover{background:#149d79;color:#fff !important;}.de-section{scroll-margin-top:30px;}@media(max-width:680px){.de-toc-inner{justify-content:flex-start;overflow-x:auto;flex-wrap:nowrap;-webkit-overflow-scrolling:touch;}.de-toc-pill{font-size:.8rem;padding:8px 13px;}}<\/style>\n<div class=\"de-toc\">\n<p class=\"de-toc-label\">On this page<\/p>\n<div class=\"de-toc-inner\"><a class=\"de-toc-pill\" href=\"#sec-the-parathyroid-glands\">The Parathyroid Glands<\/a><a class=\"de-toc-pill\" href=\"#sec-primary-hyperparathyroidism\">Primary Hyperparathyroidism<\/a><a class=\"de-toc-pill\" href=\"#sec-diagnosis\">Diagnosis<\/a><a class=\"de-toc-pill\" href=\"#sec-treatment\">Treatment<\/a><\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_intro{background-color: #ffffff !important; padding-top: 20px !important; padding-bottom: 4px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-intro\">Parathyroid disorders are among the most commonly missed diagnoses in medicine. If you have questions about calcium or parathyroid hormone, please <a href=\"\/contact\">contact our office<\/a>.<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_s1{background-color: #ffffff !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-the-parathyroid-glands\">The Parathyroid Glands<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What are the parathyroid glands and what do they do?<\/p>\n<div class=\"de-a\">\n<p>There are four parathyroid glands \u2014 each about the size of a grain of rice \u2014 embedded in the back of the thyroid. They produce parathyroid hormone (PTH), the principal regulator of blood calcium. PTH acts on bone (releases calcium), kidney (reabsorbs calcium, activates vitamin D), and intestine (increases calcium absorption from food). This system maintains blood calcium within a narrow range \u2014 essential for cardiac function, nerve transmission, and muscle contraction.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_s2{background-color: #f5f7f6 !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-primary-hyperparathyroidism\">Primary Hyperparathyroidism<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is primary hyperparathyroidism?<\/p>\n<div class=\"de-a\">\n<p>Primary hyperparathyroidism (pHPT) occurs when one or more parathyroid glands becomes autonomous \u2014 producing PTH independently of the body\u2019s calcium level. Chronically elevated PTH drives calcium out of bone and elevates blood calcium. It is caused by a single benign adenoma in approximately 85% of cases, and is one of the most common endocrine conditions in women over 50.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Is \u201casymptomatic\u201d hyperparathyroidism really symptom-free?<\/p>\n<div class=\"de-a\">\n<div class=\"de-callout\">The label \u201casymptomatic\u201d refers specifically to the absence of end-organ complications \u2014 it does not mean the patient feels well. Patients commonly report significant fatigue, cognitive difficulties, depression, anxiety, and poor sleep that improve markedly after surgical cure. We take these symptoms seriously.<\/div>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What are the symptoms and complications?<\/p>\n<div class=\"de-a\">\n<p>The classic \u201cbones, stones, groans, and psychic moans\u201d \u2014 <strong>Bones:<\/strong> Osteoporosis from PTH-driven calcium loss. <strong>Stones:<\/strong> Kidney stones from hypercalciuria. <strong>Groans:<\/strong> GI symptoms including nausea and constipation. <strong>Psychic moans:<\/strong> Depression, anxiety, cognitive impairment.<\/p>\n<p>Nonspecific symptoms including fatigue, increased thirst, and musculoskeletal aches are also common and frequently dismissed.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is normocalcemic hyperparathyroidism?<\/p>\n<div class=\"de-a\">\n<p>Normocalcemic hyperparathyroidism is a condition in which PTH is persistently elevated while blood calcium remains within the normal range \u2014 provided secondary causes have been excluded. It carries real consequences for bone density and requires surveillance and, in appropriate cases, treatment.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_s3{background-color: #ffffff !important; padding-top: 24px !important; padding-bottom: 48px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-diagnosis\">Diagnosis<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How is primary hyperparathyroidism diagnosed?<\/p>\n<div class=\"de-a\">\n<p>The biochemical diagnosis is established by finding elevated or inappropriately non-suppressed PTH alongside elevated (or high-normal) blood calcium. Diagnostic workup includes: Repeated calcium and PTH measurements, 24-hour urine calcium, vitamin D levels, kidney function, DEXA scan, and renal imaging.<\/p>\n<div class=\"de-callout\">Localization imaging (ultrasound, sestamibi scan, 4D-CT) is performed to identify the abnormal gland prior to surgery \u2014 not to make the diagnosis. The diagnosis is biochemical.<\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_s4{background-color: #f5f7f6 !important; padding-top: 24px !important; padding-bottom: 64px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-treatment\">Treatment<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">When is surgery recommended?<\/p>\n<div class=\"de-a\">\n<p>Parathyroidectomy is the only definitive cure. Surgery is recommended when any of the following criteria are met: Calcium more than 1 mg\/dL above the upper limit of normal, T-score below \u22122.5, history of fragility fracture, 24-hour urine calcium above 400 mg\/day, nephrolithiasis, or age under 50.<\/p>\n<p>We also consider surgery for patients with significant symptoms attributable to hyperparathyroidism \u2014 even if formal criteria are not met \u2014 after careful discussion.<\/p>\n<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What if surgery is not an option?<\/p>\n<div class=\"de-a\">\n<p>For patients who decline surgery or whose disease does not yet meet surgical thresholds, careful surveillance is appropriate \u2014 including annual calcium and creatinine, DEXA scan every 1\u20132 years, and periodic renal imaging.<\/p>\n<p><strong>Cinacalcet (Sensipar)<\/strong> reduces calcium levels by sensitizing the calcium-sensing receptor. It does not cure the disease or protect bone, but manages hypercalcemia in patients who cannot undergo surgery.<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dParathyroid Disorders &#038; Calcium Metabolism\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to understanding the parathyroid glands, primary hyperparathyroidism, and when treatment is needed.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text] On this page The Parathyroid GlandsPrimary HyperparathyroidismDiagnosisTreatment [\/vc_column_text][\/vc_column][\/vc_row] [vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_intro{background-color: #ffffff !important; padding-top:&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_gspb_post_css":"","footnotes":""},"class_list":["post-774","page","type-page","status-publish","hentry","description-off"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Parathyroid Disorders - Diaendo<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Parathyroid Disorders - Diaendo\" \/>\n<meta property=\"og:description\" content=\"[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_pt_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dParathyroid Disorders &amp; 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